Governor Perry vetoed the $297 million funding for Medicaid prescription drug benefits, but it has no impact because the bill has to be paid either way. Texas claims there is an overlap between Medicare and Medicaid eligibles in Texas and the state is paying twice for drug coverage on those enrollees. Wait, I assumed that. All I’ve read is said eligible…it didn’t say enrolled.
I’m not sure I get it. If a person is enrolled in Medicare and provided drug coverage, but also enrolled in Medicaid and provided drug coverage are they really counted twice? Wouldn’t Medicare be primary? Is this a PMPM calculation and not based on FFS or utilization of the benefit?
Someone clarify. I’ll have lots of further questions. Email me for a spirited discussion on this issue.